SNAPSHOT
HEALING FROM HOME By Nicholas Ruiz-Huidobro Magdits
New Haven’s low income, uninsured, and migrant communities shoulder the burden of extra mental health challenges during the pandemic.
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fter shuffling through some pages, Dr. Michelle Silva found the passage she was looking for. “Trauma waits for stillness,” she read. Silva is a clinical psychologist at the Hispanic Clinic of the Connecticut Mental Health Center. The bookshelves in her office—packed with clinical files, tomes of Sigmund Freud and Ignacio Martín-Baró, refugee children’s books, and novels like American Dirt, from which she had just read—neatly framed her Zoom background. “Usually, people can find ways to cope and keep busy,” she said. “But isolation can be stillness in some ways—a forced stillness.” As a psychologist with an interest in attachment theory and liberation psychology, which engages with themes like systemic oppression in marginalized communities, Silva wondered how the current pandemic would complicate an already challenging mental health epidemic. Quarantine, lockdown, and self-isolation, while essential to viral disease control, can be deleterious for mental health. Humans are social creatures, and the pandemic is forcing people to act against their survival instincts—to turn away from others. A recent epidemiological review by Dr. Mahbub Hossain and colleagues reported that those quarantining in isolation suffer greater levels of anxiety, depression, trauma, and other adverse mental health outcomes. On March 23, Governor Ned Lamont issued a statewide stay-at-home order. By early summer, New Haven schools and universities emptied. The streets were quiet, the silence broken only by police cars and their projected bilingual recordings of Mayor Justin Elicker urging people to social distance and wash their hands in both English and Spanish. Almost six months later, Connecticut’s consistent and precautious COVID-19 response has placed it among three other states that are ‘on track’ to contain the virus. But the social and psychological repercussions of an indefinite pandemic
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have taken their toll. Although reports like those from Mental Health America rank Connecticut among the states with best overall mental well-being, the pandemic has had a deeper impact on the mental health of New Haven’s low-income, uninsured, and migrant populations, who already disproportionately endure psychosocial stressors. The pandemic and the economic downturn it catalyzed have incited skyrocketing rates of unemployment, income loss, and food and housing insecurity. Within the New Haven Latin American community that the Hispanic Clinic serves, legal status and loss of community only exacerbates patients’ daily trials. “When we think about legal status,” said Silva, “there’s a real investment, in the current context, for them to try to keep a low profile and remain invisible if they can. The pandemic has heightened that sense of separation, of isolation, and been really, really challenging for people.” Even procedures like contact tracing, which the Centers for Disease Control and Prevention (CDC) has signaled as a key factor in slowing the spread of COVID-19, pose a perceived risk among undocumented immigrants seeking treatment. A phone call asking an undocumented person whom they have been in contact with may force them to choose between their public health duty and their family’s security. Having to grapple with a choice between one’s health and legal status, on top of everyday financial stressors, can be an anxiogenic experience. For Silva, seeing her patients struggle with these issues is particularly personal. Born to Ecuadorian immigrants in Connecticut, she grew up speaking Spanish and English. However, with her bilinguality came responsibility. Her mother has a chronic medical condition, and Silva often had to interpret interactions with doctors and medical staff. “Doing that cultural brokering and being the oldest of two,” she said, “I very early on had experiences of what it feels like to try to access services, particularly health services and insurance, not knowing the language, and being constrained by things like medical insurance.” She feels that this has made
